In this case, a 32-year-old male known to use injection drugs presented to the emergency department shortly after injecting a cotton water mixture directly into their femoral vein. The cotton had been previously used to filter drugs, and the patient was attempting to use any that had been left over. The patient described a “10 out of 10” headache, and was experiencing dizziness, nausea and vomiting. Upon exam, the patient was tachycardic and hypotensive. A full infectious work up was performed, including blood cultures. Two separate blood culture sets were positive for an organism not commonly recovered from routine blood cultures.   

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Author Information

Mimi Rey Precit, Ph.D., D(ABMM), M(ASCP)CM, Director, Clinical Microbiology and Molecular Diagnostics Laboratory, Providence Health and Services, Oregon Region.
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